DermAtlas: Online Dermatology Image Library dermatology image,botryomycosis,Splendore-Hoeppli phenomenon,mycetoma,fungal infection, deep,Madura foot,fungal infection, deep,lymphedema,fungal infection, deep,fungal infection, deep,fungal infection, deep

© 2001-2010, DermAtlas	*Image Name:*	botryomycosis_1_060410	*File Type:*	jpg
	*Diagnosis:*	BOTRYOMYCOSIS / SPLENDORE-HOEPPLI PHENOMENON / MYCETOMA	*Category:*	infections and infestations / histologic finding
	*Body Site:*	leg	*Age:*	51 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	Histologic sections of skin show a mixed inflammatory infiltrate, extending from an ulcerated epidermis to the subcutaneous tissue. There are zones of necrosis and abundant neutrophils. Scattered within the infiltrate are basophilic concretions with a brightly eosinophilic rim.
	*Comments:*	This 51-year-old woman had chronic ulcers of her lower extremities. Botryomycosis is an unusual finding in skin biopsies. The lesions are similar to mycetoma, but the the central areas are bacterial colonies (often Staphylococcus aureus) and not filamentous fungi. Immunoglobulin is abundant within the concretions. These structures have a characteristic brightly eosinophilic peripheral band, the Splendore-Hoeppli phenomenon.
	*Related Images:*	botryomycosis_2_060410

© 2001-2010, DermAtlas	*Image Name:*	botryomycosis_2_060410	*File Type:*	jpg
	*Diagnosis:*	BOTRYOMYCOSIS / SPLENDORE-HOEPPLI PHENOMENON / MYCETOMA	*Category:*	infections and infestations / histologic finding
	*Body Site:*	leg	*Age:*	51 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	At high power, the center of the concretion consists of basophilic granular material. A brightly eosinophilic band encases the bacteria.
	*Comments:*	This 51-year-old woman had chronic ulcers of her lower extremities. Botryomycosis is an unusual finding in skin biopsies. The lesions are similar to mycetoma, but the the central areas are bacterial colonies (often Staphylococcus aureus) and not filamentous fungi. Immunoglobulin is abundant within the concretions. These structures have a characteristic brightly eosinophilic peripheral band, the Splendore-Hoeppli phenomenon.
	*Related Images:*	botryomycosis_1_060410

© 2001-2010, DermAtlas	*Image Name:*	Mycetoma_1_051017	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / FUNGAL INFECTION, DEEP	*Category:*	tropical medicine / infections and infestations
	*Body Site:*	foot	*Age:*	60 years
	*Contributor:*	Ali Zarei Mahmoudaba, MD
	*Description:*	dramatic edema with hyperpigmented nodules and plaques many with overlying bloody ulcers and crusts
	*Comments:*	This 60-year-old woman, who had been living in the village of Ahwaz, Iran, injured her foot on a stick while working on a farm 20 years ago. Eighteen months later she developed progressive swelling of her foot.

© 2001-2010, DermAtlas	*Image Name:*	mycetoma_1_050808	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / MADURA FOOT	*Category:*	infections and infestations / lumps & bumps (plaques, nodules, tumors)
	*Body Site:*	leg / foot ankle	*Age:*	12 years
	*Contributor:*	Ben Hidalgo-Matlock, MD
	*Description:*	large rubbery skin colored mass with purple nodules and fistulas
	*Comments:*	This 12-year-old woman developed a large expanding mass with multiple fistulas and osteomyelitis 2 months after suffering an abrasion to the ankle.

© 2001-2010, DermAtlas	*Image Name:*	mycetoma_2_040219	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / MADURA FOOT	*Category:*	tropical medicine / infections and infestations
	*Body Site:*	foot	*Age:*	43 months
	*Contributor:*	Valerie Desgroseilliers
	*Description:*	diffuse unilateral induration with subcutaneous nodules and sinus tracts
	*Comments:*	This 43-year-old woman from Mali in western Africa developed painful swelling in her left toe over 20 years ago following an injury from a thorn. Over several years the lesions pread to her ankle with subcutaneous nodules and draining sinuses involving most of her left foot. The foot became excritiatingly painful after even minor trauma. These findings were most consistent with mycetoma which is characterizec by the triad of tumefaction, draining sinuses, and the presence of grains in the exudate. Mycetoma occurs primarily in the tropics and the foot is most commonly involved producing the clinical picture of Madura foot. Mycetoma can be caused by true fungi (eumycetic mycetomas), filamentous bacteria of the order Actinmycetales (actinomycetic mycetoma), and other bacteria (botrymycosis). A skin biopsy for pathology and culture for fungi and bacterai are necessary to make a specific diagnosis and select appropriate antibacterial or antifungal therapy.
	*Related Images:*	mycetoma_1_040219

© 2001-2010, DermAtlas	*Image Name:*	mycetoma_1_040219	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / MADURA FOOT	*Category:*	tropical medicine / infections and infestations
	*Body Site:*	foot	*Age:*	43 months
	*Contributor:*	Valerie Desgroseilliers
	*Description:*	diffuse unilateral induration with subcutaneous nodules and sinus tracts
	*Comments:*	This 43-year-old woman from Mali in western Africa developed painless swelling, subcutaneous nodules and draining sinuses on her left foot. These findings were most consistent with mycetoma which is characterizec by the triad of tumefaction, draining sinuses, and the presence of grains in the exudate. Mycetoma occurs primarily in the tropics and the foot is most commonly involved producing the clinical picture of Madura foot. Mycetoma can be caused by true fungi (eumycetic mycetomas), filamentous bacteria of the order Actinmycetales (actinomycetic mycetoma), and other bacteria (botrymycosis).
	*Related Images:*	mycetoma_2_040219

© 2001-2010, DermAtlas	*Image Name:*	Mycetoma_6_030511	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / FUNGAL INFECTION, DEEP / LYMPHEDEMA	*Category:*	granulomatous disorder / infections and infestations
	*Body Site:*	heel / foot leg	*Age:*	45 years
	*Contributor:*	Shahbaz A. Janjua, MD
	*Description:*	diffuse edema, scaling, and thickening of the skin with multiple clustered warty nodules and abcesses
	*Comments:*	This 45-year-old farm worker presented developed a wound on the medial aspect of his left foot caused by cactus thorn while working in the field about 25 years ago. Unfortunately, the wound was treated by his father with a home remedy, the application of a donkey feces over the wound for several days. Multiple abcesses and nodules associated with edema formed over the affected area and gradually spread to the rest of his left foot and lower leg. There were no draining abcesses and fistulae, but the patient had to frequently drain the subcutaneous abcesses with a a shaving blade to reduce the pain. Thick purulant granular fluid was drained from the medial aspect of his foot and sent for microscopic examination and bacterial culture. Mycetoma is a chronic, granulomatous disease of the skin and subcutaneous tissue, which sometimes involves muscle, bones and neighboring organs. Fungal and/or bacterial organisms can trigger the chronic granulomatous reaction.
	*Related Images:*	All related Images Mycetoma_1_030511 Mycetoma_2_030511 Mycetoma_3_030511 Mycetoma_4_030511 Mycetoma_5_030511

© 2001-2010, DermAtlas	*Image Name:*	Mycetoma_5_030511	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / FUNGAL INFECTION, DEEP / LYMPHEDEMA	*Category:*	granulomatous disorder / infections and infestations
	*Body Site:*	heel / foot	*Age:*	45 years
	*Contributor:*	Shahbaz A. Janjua, MD
	*Description:*	diffuse edema, scaling, and thickening of the skin with multiple clustered warty nodules and abcesses
	*Comments:*	This 45-year-old farm worker presented developed a wound on the medial aspect of his left foot caused by cactus thorn while working in the field about 25 years ago. Unfortunately, the wound was treated by his father with a home remedy, the application of a donkey feces over the wound for several days. Multiple abcesses and nodules associated with edema formed over the affected area and gradually spread to the rest of his left foot and lower leg. There were no draining abcesses and fistulae, but the patient had to frequently drain the subcutaneous abcesses with a a shaving blade to reduce the pain. Thick purulant granular fluid was drained from the medial aspect of his foot and sent for microscopic examination and bacterial culture. Mycetoma is a chronic, granulomatous disease of the skin and subcutaneous tissue, which sometimes involves muscle, bones and neighboring organs. Fungal and/or bacterial organisms can trigger the chronic granulomatous reaction.
	*Related Images:*	All related Images Mycetoma_1_030511 Mycetoma_2_030511 Mycetoma_3_030511 Mycetoma_4_030511 Mycetoma_6_030511

© 2001-2010, DermAtlas	*Image Name:*	Mycetoma_4_030511	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / FUNGAL INFECTION, DEEP / LYMPHEDEMA	*Category:*	granulomatous disorder / infections and infestations
	*Body Site:*	foot / toe web	*Age:*	45 years
	*Contributor:*	Shahbaz A. Janjua, MD
	*Description:*	diffuse edema, scaling, and thickening of the skin with multiple clustered warty nodules and abcesses
	*Comments:*	This 45-year-old farm worker presented developed a wound on the medial aspect of his left foot caused by cactus thorn while working in the field about 25 years ago. Unfortunately, the wound was treated by his father with a home remedy, the application of a donkey feces over the wound for several days. Multiple abcesses and nodules associated with edema formed over the affected area and gradually spread to the rest of his left foot and lower leg. There were no draining abcesses and fistulae, but the patient had to frequently drain the subcutaneous abcesses with a a shaving blade to reduce the pain. Thick purulant granular fluid was drained from the medial aspect of his foot and sent for microscopic examination and bacterial culture. Mycetoma is a chronic, granulomatous disease of the skin and subcutaneous tissue, which sometimes involves muscle, bones and neighboring organs. Fungal and/or bacterial organisms can trigger the chronic granulomatous reaction.
	*Related Images:*	All related Images Mycetoma_1_030511 Mycetoma_2_030511 Mycetoma_3_030511 Mycetoma_5_030511 Mycetoma_6_030511

© 2001-2010, DermAtlas	*Image Name:*	Mycetoma_3_030511	*File Type:*	jpg
	*Diagnosis:*	MYCETOMA / FUNGAL INFECTION, DEEP / LYMPHEDEMA	*Category:*	granulomatous disorder / infections and infestations
	*Body Site:*	foot / ankle leg	*Age:*	45 years
	*Contributor:*	Shahbaz A. Janjua, MD
	*Description:*	diffuse edema, scaling, and thickening of the skin with multiple clustered warty nodules and abcesses
	*Comments:*	This 45-year-old farm worker presented developed a wound on the medial aspect of his left foot caused by cactus thorn while working in the field about 25 years ago. Unfortunately, the wound was treated by his father with a home remedy, the application of a donkey feces over the wound for several days. Multiple abcesses and nodules associated with edema formed over the affected area and gradually spread to the rest of his left foot and lower leg. There were no draining abcesses and fistulae, but the patient had to frequently drain the subcutaneous abcesses with a a shaving blade to reduce the pain. Thick purulant granular fluid was drained from the medial aspect of his foot and sent for microscopic examination and bacterial culture. Mycetoma is a chronic, granulomatous disease of the skin and subcutaneous tissue, which sometimes involves muscle, bones and neighboring organs. Fungal and/or bacterial organisms can trigger the chronic granulomatous reaction.
	*Related Images:*	All related Images Mycetoma_1_030511 Mycetoma_2_030511 Mycetoma_4_030511 Mycetoma_5_030511 Mycetoma_6_030511